改良的德国多中心成年人急性淋巴细胞白血病研究组方案临床应用研究

目的 分析改良的德国多中心成年人急性淋巴细胞白血病研究组(GMALL)方案治疗成年人急性淋巴细胞白血病(ALL)的疗效和安全性.方法 2005年1月至2009年12月共37例新诊断的ALL患者,接受改良的GMALL方案单纯化疗,对其进行回顾性分析,并与同期接受该院常规方案治疗的44例成年ALL患者进行对比分析.结果 改良GMALL方案的累积完全缓解(CR)率为89.2%(33/37),1、2、3及4年累积总生存(0S)率分别为77.5%、48.0%、40.0%和40.0%.主要不良反应为3～4级血液学毒性和感染,不良反应易于控制,治疗相关死亡率低.改良GMALL方案组的OS优于该院常规方案组.结论 改良的GMALL方案治疗成年人ALL疗效满意,不良反应可以耐受,值得临床推广.     

Knockdown of akt sensitizes osteosarcoma cells to apoptosis induced by Cisplatin treatment

Akt plays an important role in the inhibition of apoptosis induced by chemotherapy and other stimuli. We therefore investigated if knockdown of Akt2 promoted drug-induced apoptosis in cultured osteosarcoma cells in vitro. SAOS-2 cells were transfected with Akt2 siRNA. The sensitivity of the transformed cell line to the chemotherapeutic drug cisplatin was assessed. Reduced expression of Akt2 did not directly inhibit the growth rate of the transfected cells; however, it significantly increased their sensitivity to cisplatin. Knockdown of Akt2, together with cisplatin treatment, promoted the expression of p53 up-regulated modulator of apoptosis (PUMA). It is possible that the augmentation of cisplatin cytotoxicity may be mediated by PUMA activation. The results of this study suggest that knockdown of Akt2 expression may have therapeutic applications in enhancing the efficacy of chemotherapy in patients with osteosarcoma.     

低剂量化疗药的TACE术对原发性肝癌患者肝纤维化的影响

目的探讨低剂量与常规剂量化疗药物经动脉导管灌注化疗栓塞术（transcather arterial chemoembolization,TACE）对原发性肝癌患者血清肝纤维化指标的影响。方法 38例原发性肝癌患者按随机数字表法分为A组（18例）、B组（20例）。A组应用低剂量化疗药物,B组应用常规剂量化疗药物。均行TACE术,TACE术≥2次,手术间隔4周以上,分别检测第1次术前、术后7 d,第2次术后1个月患者血清中纤维化指标,包括透明质酸（HA）、层粘连蛋白（LN）、人Ⅲ型前胶原（hPC-Ⅲ）、Ⅳ型前胶原（Ⅳ-C）,共3次。同时观察近期远期疗效。结果 TACE术前血清肝纤维化指标2组间差异无统计学意义（P〉0.05）,低剂量组术后肝纤维化指标低于常规组（P〈0.05）,低剂量组术后肝纤维化指标与术前比较差异无统计学意义（P〉0.05）。低剂量组与常规剂量组中位生存期分别为12.2、11.8个月;6个月,1、2年生存率分别为83.3%、70.0%,61.1%、50.0%,33.3%、25.0%,差异无统计学意义（P〉0.05）。结论原发性肝癌患者采用低剂量化疗药物TACE术可取得与常规剂量化疗药物一样的疗效,减轻肝纤维化的发生。     

三维适形放疗联合吉西他滨介入化疗治疗局部晚期胰腺癌

目的评价三维适形放疗联合吉西他滨介入化疗对局部晚期胰腺癌的治疗效果。方法将40例经手术病理或细胞学诊断的局部晚期胰腺癌患者分为治疗组、对照组各20例。治疗组采用三维适形放疗联合吉西他滨介入化疗,对照组采用吉西他滨介入化疗,观察两组疗效、生存率及毒副反应。结果在治疗组,总有效率为40%;治疗后6、12个月生存率分别为65%、45%;中位生存时间为11个月。均高于对照组（P〈0.05）。毒副反应2组比较无显著差异（P〉0.05）。结论三维适形放疗联合吉西他滨介入化疗对局部晚期胰腺癌患者能控制肿瘤生长,缓解疼痛,改善生存质量,且患者耐受良好。     

局限期小细胞肺癌化疗联合同期三维适形超分割放疗的临床研究

目的探讨局限期小细胞肺癌化疗联合同期三维适形超分割放疗的疗效和生存率。方法将60例局限期小细胞肺癌患者按随机数字表法分为2组：同步放化疗组（n=30）和序贯治疗组（n=30）。2组化疗均采用EP方案（VP-16 75mg.m-2.d-1,d1-d5＋DDP 80mg.m-2.d-1,d1）化疗4～6个周期;放疗采用三维适形放疗（3DCRT）,6MV-X线,超分割照射,1.5Gy.次-1,2次.d-1,总剂量45Gy.30次-1。同步放化疗组从化疗第1天开始实施三维适形超分割放疗。序贯治疗组从化疗4周期后采用三维适形超分割放疗。2组中治疗达完全缓解（CR）的患者行脑预防性照射（PCI）。结果同步放化疗组和序贯治疗组的完全缓解率为46.7%和16.7%（P=0.025）,总有效率分别为83.3%和53.3%（P=0.013）;2组毒副作用比较差异无统计学意义（P〉0.05）;同步放化疗组和序贯治疗组1、2、3年生存率分别为86.7%、63.3%、30.0%和73.3%、30.0%、16.7%,同步放化疗组优于序贯治疗组（P=0.035）;同步放化疗组和序贯治疗组局部复发率分别为16.7%和40.0%（P=0.047）,远处转移率分别为36.7%和66.7%（P=0.038）。结论化疗联合同期三维适形超分割放疗对局限期小细胞肺癌具有较好的疗效,其完全缓解率和总生存率得到明显提高。     

口腔癌术后化疗早期血小板升高相关因素研究

目的：探讨口腔癌患者术后化疗早期血小板升高的意义。方法：查阅2008年1月至2011年1月在我院行术后化疗的86例口腔癌患者病历资料,统计化疗前及化疗第一至四周期PLT数,探寻血小板数（Platdets,PLT）的变化规律;选取2011年8月至2012年7月在我院行术后化疗46例口腔癌患者,20例健康人作为对照组,晨起空腹采血,检测血液常规,分离血清,ELISA法检测血清中Fit-3配体（Flt-3 ligand,FL）及血小板生成素（Thrombopoietin,TPO）含量。结果：①2008年1月至2011年1月86例口腔癌患者有27例化疗期间出现PLT先升高再降低的现象,且升高较化疗前具有显著性（P〈0．05）。②2011年8月至2012年7月46例口腔癌患者化疗前PLT各参数与对照组均无明显差异（P〉0．05）,而化疗后与化疔前相比,PLT、血小板压积（Platecrit,PCT）明显升高（P〈0．05）,血小板平均体积（MeanPlateletVolume,MPV）、血小板分布宽度（Platelet distribution width,PDW）则明显降低（P〈0．05）;化疗前血清中FL、TPO与对照组无明显差异（P〉0．05）,化疗后与化疗前相比,FL明显降低（P〈0．05）,TPO差异不具有显著性（P〉0．05）。结论：术后11．5个月行化疗时,骨髓造血功能已基本恢复正常,而化疗后骨髓造血功能确实受到一定的抑制;化疗早期血小板升高是由于外周血中血小板破坏减少,而非骨髓生成血小板增多所致;化疗早期血小板升高不能代表肿瘤治疗无效,或者癌细胞发生转移。     

A Novel Stimuli-Responsive Magnetite Nanocomposite as De Novo Drug Delivery System

A novel stimuli-responsive magnetite nanocomposite as de novo drug delivery system for cancer chemotherapy is developed successfully through the incorporation of magnetite nanoparticles into PEG-b-(PNIPAAm-b-PAA)₂ copolymer. The chemical structures of samples were characterized using FTIR and ¹H NMR spectroscopies. Furthermore, thermal property, morphology, size, and magnetic properties of the nanocomposite were investigated. The DOX loading and encapsulation efficiencies as well as stimuli-responsive drug release ability of the nanosystem were studied. As results, at pH 5.3 and temperature of 41°C the nanocomposite exhibited higher drug release values, which qualified it for cancer chemotherapy according to especial features of cancerous tissue.     

The success and the challenge of all-trans retinoic acid in the treatment of cancer

Abstract

All-trans retinoic acid (ATRA), an active metabolite of vitamin A, plays important roles in cell proliferation, cell differentiation, apoptosis, and embryonic development. The effects of ATRA are mediated by nuclear retinoid receptors as well as non-genomic signal pathway, such as MAPK and PKA. The great success of differentiation therapy with ATRA in acute promyelocytic leukemia (APL) not only improved the prognosis of APL but also spurred the studies of ATRA in the treatment of other tumors. Since the genetic and physiopathological simplicity of APL is not common in human malignancies, the combination of ATRA with other agents (chemotherapy, epigenetic modifiers, and arsenic trioxide, etc) had been extensively investigated in a variety of tumors. In this review, we will discuss in details about ATRA and its role in cancer treatment.     

Application of optimal control theory to analysis of cancer chemotherapy regimens

Cancer chemotherapy with application of one drug is studied. The negative and inhibiting effect of the tumor on normal cells is taken into account. Under certain assumptions, we determine the optimal regimen that minimizes the tumor burden at the end of a fixed period of therapy while maintaining the normal cell population above a prescribed level.